Active NPI
Vivian L Stidvent, LPC
- Professional Counselor
- Waco, TX
National Provider Identifier
1336366830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8935
- Practice address
- 1105 Jefferson Ave
Waco, TX 76701-1212 - Phone
- (254) 752-7889
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8935 | TX | Primary |
Addresses
Primary practice location
1105 Jefferson Ave
Waco, TX 76701-1212
Mailing address
8216 Teakwood Dr
Waco, TX 76712-2426
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8935 | TX | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336366830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8216 TEAKWOOD DR",
"city": "WACO",
"state": "TX",
"postal_code": "767122426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1105 JEFFERSON AVE",
"city": "WACO",
"state": "TX",
"postal_code": "767011212",
"telephone_number": "254-752-7889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STIDVENT",
"first_name": "VIVIAN",
"middle_name": "L",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "8935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waco, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.